DESCRIPTION: An observational, longitudinal study is proposed to continue following the survivors in a prevalence cohort of older black and older white patients on dialysis, to investigate the contribution of quality of life (QOL) variables to these patients' long-term survival and to continue assessing longitudinal change in these older patients QOL. A new, incident cohort of dialysis patients will also be defined, for whom medical care variables, patient behavior variables, and their interactions, will be related to self-assessed QOL outcomes. The vital status of this cohort will also be monitored. The primary aims of this research are: 1) to identify potentially manipulatable predictors of health-related QOL for end-stage renal disease patients treated by chronic dialysis, and 2) to investigate whether observed changes in potentially manipulatable factors are related to changes in dialysis patients' health-related QOL. If observed changes in potentially manipulatable factors are related to observed changes in QOL, these findings could indicate the utility of designing a clinical trial to test the observed relationships.